Vapes and e-cigarettes started out as a way for adults to stop smoking harmful cigarettes containing tobacco. However, the annual 2022 National Youth Tobacco Survey found that more than 2.5 million middle and high school students use e-cigarettes and suggests teen dependency on Electronic Nicotine Delivery Systems (ENDS) like vapes and e-cigarettes. This is a concerning 500,000 increase from the 2021 National Youth Tobacco Survey.
On October 12, 2021, the U.S. Food and Drug Administration (FDA) authorized the marketing of three ENDS through a new tobacco marketing application called the Premarket Tobacco Product Application. Since then, the FDA has approved over 20 authorizations of ENDS from three different companies- the R.J. Reynolds Vapor Company, NJOY LLC, and Logic Technology Development LLC.
With FDA authorization, R.J. Reynolds Vapor Company, NJOY LLC, and Logic Technology Development LLC can legally sell their vape and e-cigarette products in the U.S. That doesn’t mean these products are approved. In fact, FDA authorization just means that the FDA believes these products can be beneficial for existing tobacco smokers with already significant health risks. FDA approval means a product is safe and effective; FDA authorization means that
product can be a good alternative for adults to quit smoking.
A serious implication of FDA-authorized vapes and e-cigarettes is the false sense of security that teens can have with using vapes and e-cigarettes. Teens can misunderstand that vapes and e-cigarettes, specifically these particular brands, are safe for them to use. They can misinterpret the FDA’s brand marketing green-lighting to be a positive and safe endorsement. However, the FDA still considers vapes and e-cigarettes harmful to everyone.
According to the 2022 National Youth Tobacco Survey findings, 12.5% of the 2.5 million U.S. middle and high school students who use e-cigarettes use an FDA-authorized brand. Additionally, 14.1% of all high school students and 3.3% of all middle school students use e-cigarettes. Of those high school and middle school students who use e-cigarettes, about 85% use flavored ENDS.
However, these statistics and results can not be directly compared to previous year’s National Youth Tobacco Surveys before 2020 because of the change in methodology used for surveying teens during the COVID-19 pandemic. So, this data set can potentially be misleading due to COVID-19 protocols, but the results still display a high number of teen nicotine users.
Vapes and E-cigarettes contain nicotine, an addictive substance found in tobacco plants. Nicotine poses significant health threats like harm to brain development, physiological functioning, and vulnerability to other addictive behaviors which are detrimental to growing teens. These threats are amplified for teens who use vapes or e-cigarettes.
One study found that nicotine negatively affects mental health, and additional research suggests that vaping can increase susceptibility to COVID-19. Nicotine acts as a depressant, causing worse symptoms in cases of vulnerable teenagers experiencing heavy emotions, like the effects of isolation from the COVID-19 pandemic. During the beginning of COVID-19, signs of depression and anxiety increased in teens who use vapes and e-cigarettes. With FDA authorization, these numbers can concerningly increase as teens continue to use vapes and e-cigarettes.
Additionally, teenagers who use vapes or e-cigarettes experience COVID-19 symptoms more frequently and get diagnosed with COVID-19 more often than teen non-users. This is most likely due to nicotine addiction taking a toll on the body, causing vulnerability for pathogens and bacteria to enter the body more easily. The respiratory and immune systems are at risk when teens are exposed to nicotine via vapes and e-cigarettes, which cannot only lead to vulnerability to COVID-19, but to other illnesses too.
In 2019, Congress raised the age requirement to purchase tobacco products from 18 to 21 years old in an attempt to reduce illegal sales to minors and still target adults using cigarettes. This is a great effort, however, just from the year 2021 to 2022, the number of minors using vapes and e-cigarettes has increased.
The FDA claims to use a public health approach to reduce the risk of health outcomes to the whole population, including teens. The FDA’s tobacco product violations include prohibiting the sale of flavored cigarettes and strict regulations on marketing.
Flavored cigarettes and ENDS products are enticing to middle and high school students because they seem fun and tasteful. Flavored cigarettes can lead to nicotine addition and the effects of flavored tobacco products are harmful to the body. About 85% high school and middle school students surveyed in the 2022 National Youth Tobacco Survey who use e-cigarettes, use flavored ENDS. Flavored cigarettes are alarmingly enticing to teens, but the FDA’s regulations potentially slows vape and e-cigarette prevalence in teens.
Vuse, manufactured by R.J. Reynolds Vapor Company, is the second most commonly used vape brand among all students who use vapes. The FDA has allowed the marketing of these commonly known vape devices to be sold at the risk of youth’s vulnerability to nicotine usage.
Marketing plays a critical role in vaping and e-cigarette exposure to youth. The FDA limits promotions, sponsorships, and labels. Strict government regulations on nicotine marketing can help teens see vapes and e-cigarettes as less enticing.
Finally, the Centers for Disease Control and Prevention (CDC) and FDA state they are committed to Youth Tobacco Education. Both provide resources that schools, companies, and industries can use to help further promote the dangers of nicotine via vape and e-cigarettes. The CDC has resources available like information sheets, fact sheets, and infographics. The FDA promotes “The Real Cost Campaign” that attempts to target teen-relevant platforms to promote the dangers of nicotine in vapes and e-cigarettes. The FDA also partners with TeenSmokeFree.gov to provide resources for current middle and high school students addicted to nicotine using ENDS products.
Vapes and e-cigarettes increase health risks in teens and the current FDA authorization of more ENDS products increases the risk of teens being introduced to nicotine. The FDA’s marketing decision is based on decreasing the use of tobacco for adult cigarette smoker already hooked on existing tobacco products. However, vapes and e-cigarettes are not safe for anyone to use and the legal marketing of vapes can negatively impact how teens continue to perceive e-cigarettes with a false sense of security leading to serious health repercussions.
Even FDA-authorized products can be harmful, especially for developing brains. This is why it’s crucial to focus on prevention and education rather than just regulation. For those looking for alternatives to traditional smoking or vaping, an electric hookah could be an option for adults who want a similar experience without the same levels of harmful chemicals. However, even with alternatives, it’s vital to promote responsible use and ensure these products don’t end up in the hands of minors. Proper awareness is key.